From the Research
The recommended treatment for carpal tunnel syndrome (CTS) during pregnancy primarily involves conservative management, with wrist splinting as the first-line treatment, as supported by the most recent study 1. This approach is based on the understanding that CTS in pregnancy is often self-limiting and resolves after delivery. The use of neutral-position splints worn at night and during symptom-provoking activities can help alleviate symptoms. Some key points to consider in the management of CTS in pregnancy include:
- Physical therapy focusing on nerve gliding exercises and stretching can provide relief 2.
- Lifestyle modifications are important, including frequent breaks from repetitive hand activities, ergonomic adjustments to workstations, and avoiding extreme wrist positions.
- For pain management, acetaminophen (Tylenol) is considered safe during pregnancy at recommended doses (up to 3000 mg daily in divided doses) 3.
- Local corticosteroid injections may be considered in severe cases unresponsive to conservative measures, though typically physicians prefer to delay this until after delivery if possible 3.
- Surgical intervention (carpal tunnel release) is rarely needed during pregnancy and is usually postponed until after delivery 4, 5. The condition occurs due to increased fluid retention during pregnancy causing compression of the median nerve within the carpal tunnel, explaining why conservative measures focusing on reducing pressure and inflammation are most appropriate during this temporary state. Given the potential for CTS to resolve spontaneously postpartum, a conservative approach is generally preferred, with the most recent guidance emphasizing the importance of early diagnosis and a personalized approach to manage this pathology 1.